Provider Demographics
NPI:1922262096
Name:ALBERT, EMILY LAZZARI (MD)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:LAZZARI
Last Name:ALBERT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:BETH
Other - Last Name:LAZZARIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:750 E ADAMS ST
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13210-2342
Mailing Address - Country:US
Mailing Address - Phone:315-464-1775
Mailing Address - Fax:315-464-1937
Practice Address - Street 1:750 E ADAMS ST
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210-2342
Practice Address - Country:US
Practice Address - Phone:315-464-1775
Practice Address - Fax:315-464-1937
Is Sole Proprietor?:No
Enumeration Date:2008-07-17
Last Update Date:2014-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY257016208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03255218Medicaid
NY03255218Medicaid
NYP01261399Medicare PIN